Professional Documents
Culture Documents
CAVITY PREPARATION
How?
• Decreasing pressure
• Using tools with high cutting
efficiency
• The use of copious,
multidirectional, and
isothermic coolant
Prevention of chemical irritation :
7. Avoid using of caustics and or
chemicals in cavity toilet. e.g., alcohol
or phenolic materials
The irritation to the pulp is
mainly through admission of
bacteria and toxins through
leakage space at restoration /
tooth interface
Prevention of bacterial
irritation:
1. sterilization of instruments, burs and
armamentarium.
2. the use of rubber dam sp. In deep
cavities
3. the use of certified conditioners,
primers and adhesives for achievement
of proper sealing
II- Control of caries:
Caries may recur at the margins and get
detected or may spread underneath it until it
becomes so complicated to save the tooth.
It requires:-
1. Removal of all carious enamel and dentin
on principles.
2. Cavity outline form should include all pits
& fissures and vulnerable areas.
Isthmus portion.
Proximal portion.
Occlusal Portion:
Depends on:
1. Extension of caries in enamel.
2. All retentive areas should be included in
cavity design.
3. All short, loose, undermined enamel rods
should be eliminated.
4. Lateral spread of caries along D.E.J.
5. Cavities which are closely approached to each
other should be united into one cavity.
Isthmus Portion:
Amalgam:
Wider than the occlusal
and narrower than the
proximal in order not to
create artificial necking
at this critical area with
subsequent isthmus
fracture.
Cast gold:
The same width of
occlusal portion.
Proximal Cavity:
Depends on:
1. Size, site & form of the contact area.
2. Contact areas in proximal cavities should be
included within the cavity
outline. i.e. cavity
margins are placed pass
the contact area with
the adjacent tooth
proximally.
Ingrham’s Lines:
These lines are detected for proper
freeing of contact: they describe the shape of
the buccal and lingual walls of the proximal
cavity at different situations of the contact
area.
A) Straight line:
§ In cases of open contact.
B) Universal curve:
§ I n c a s e s o f w i d e
embrasure and broad
contact.
C) Reverse curve:
§ In cases of tight contact
& small embrasure.
Reverse curve is done normally in the
buccal wall of class II.
0.25- 0.5mm
In class II cavity
preparation for amalgam
restoration: the proximal
box is inverted truncated
cone.
• Buccal wall // occlusal 2/3 of the buccal surface.
• Lingual wall // long axis of the tooth.
• The inverted cone should have slight convergence
of the buccal & lingual wall in gingivo-occlusal
direction.
• Sever convergence is contraindicated as it leads to
fracture of the restoration at the isthmus portion.
Other factors affecting outline form:
• The type of occlusion and force of
mastication: heavy occlusal bite
necessitates slight modification of
outline form.
• Physical properties of the restorative
material will directly influence the
outline form through determining the
amount of extension.
• Requirements of esthetic versus
convenience,
• e.g. In anterior teeth and premolars:
conservative class II & III is required to
obtain esthetic.
• Age and caries susceptibility.
• Oral hygiene of the patient.
Outline form of Cervical
cavity preparations:
Depends on:
• Caries extension.
• Esthetic requirements
CONCLUSION
The main significance of outline form is
primarily the removal of actual defects &
prevention of caries recurrence about the
margins of the restoration without
extensive extension of the cavity margins.
2. Resistance & Retention form:
Resistance form:
Design features applied to the cavity
preparation which provide for structural
integrity of both restoration and tooth. Or,
It’s the form given to the cavity which
provides the structural integrity of both tooth
& restoration which allows them to resist
functional forces of mastication without
fracture.
Factors affecting resistance form:
1. O cclusal load involving its Magnitude,
Direction: either centric or eccentric &
Character: whether in or out of occlusion or
static, dynamic or cyclic.
2. Design of the cavity:
• Walls direction: must
be // or ⊥ to the
direction of expected
masticatory forces i.e. //
or ⊥ to the occlusal
plane.
Yes
• Line & Point angles:
must not be sharp to avoid
stress concentration that
leads to tooth fracture.
T h e s e a t o f t h e
restoration is ⊥ to the
proposed force so,
neutralize the resulting
stresses.
The tendency for splitting the buccal &
lingual cusps of bicuspids & molars by
forces of mastication through the
restoration is greatly diminished.
A- Chemical retention:
• primary valence bonding : is strong and
stable.
• It is not achievable except for the glass
ionomer restorations
B- Mechanical retention:
• This is the principle mechanism of
retention.
Types:
1. Micro-mechanical retention: This is the most
conservative mechanism of retention. This is
achieved by Acid etching of enamel and
dentin.
2. Macro-mechanical retention: It is the main
retention mechanism employed for metallic
restorations
1. Axial retentive features:
Frictional retention:
parallelism between walls
in cast restorations.( for
indirect restorations)
Undercuts in
dentin where the
interior of the cavity
is wider than the
exterior.( for direct
restorations)
Dentin ledge:
An area of flat pulpal floor at routine
depth all around the hemispherical cavity. OR
at least 3 points of flat pulpal floor.
It’s done by using an inverted cone bur.
Lateral retention:
Dove tail lock:
in compound cavities which
prevent lateral displacement
of the restoration.
Accessory retentive features:
Proximal axial grooves
in class II: in axio-buccal &
axio-lingual line angles.
These grooves are made on
the expense of buccal &
lingual walls rather than
the axial.
Incisal or occlusal &
gingival grooves in class V.
Pinholes:
- Pinhole without pin:
as in class III.
Intra-radicular retention:
by embedding a post in
root canal treated tooth.
Reverse bevel: in the
gingival wall of the
proximal cavity of class
II cast gold restoration
which prevents lateral
displacement.
Cement interlock: in cast restorations.
N.B. Cement interlock is not a design feature
but it’s a retentive mean.
Means of retention
For axial displacement For lateral displacement
Frictional retention Dove- tail lock
Undercuts Proximal axial grooves
Pins Reverse bevel
Posts Pin, slots and Posts
Cement interlock Acid etching technique
Acid etching technique Extension for retention
The relation between
RESISTANCE & RETENTION
Objectives:
1. Elimination of bacteria, debris and saliva.
2. Removal of remnants of dentin chips and
temporary restoration.
3. To improve adaptation and hinder the
recurrence of decay around the restoration.
4. Prepare and condition the tissues to receive the
entitled restorative material.
Smear layer:
A thin microscopic layer formed when using
hand or rotary instrument against cavity walls.
formed of: collagen of dentin, debris, saliva
(mucin) & microorganisms.
For removal of smear layer:
1) EDTA.
2) Malic acid.
3) Phosphoric acid.
4) Polyacrylic acid.
The concept of toilet of the cavity has
been changed with the advancement of
restorative materials.